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Monday, September 11, 2017

When?

When: Interrogative Adverb.
At what time; how soon

Soon: Adverb.
In or after a short time; early

Shortly: Adverb
In a short time; soon

Now: Adverb
At the present time or moment

Anon: Adverb
Soon, shortly

When we ask the question "When would you like to come in for your prescription?", we are trying to plan our day in the most efficient manner in order to ensure your prescription is ready by your intended arrival time. It really makes no sense for me to work on your prescription right now if you intend to wait until tomorrow, or the weekend, to retrieve it. This allows me to dedicate my time and energy to high priority prescriptions such as antibiotics and ER/post-surgery medications and, well, flu shots. When you have a prescription that requires urgent attention, you can appreciate all the other patients communicating honest pickup times with us.

In the question "WHEN?", we are asking for a time. It can be exact or a ballpark estimate. The correct answer to "At what time would you like to pick up your prescription?" is NOT "later"; nor is it "soon", "shortly", or "today". Those are not times on my clock.

If you choose to give me vague answers, I shall try to out-vague you.

Pt: (on the phone) Did you receive my prescription(s) from my prescriber?
CP: We did. They just arrived in my queue but we have yet to process them. "When (at what time) did you want to come in for them?"
Pt: As soon as they're ready.
CP: Okay. We will see you then.
Pt: Wait. When will they be ready?
CP: Oh. Anon. <click>

or

CP: When did you want to come in for them?
Pt: Later.
CP: Okay. See you later, alligator.
Pt: How much later?
CP: After a while, crocodile. <click>

Yes. This is an endless debate.
How do we phix it?
As I stated, we get the patients to commit to a time.
When they are vague, we give them longer-than-necessary estimates. However, this rarely works because, regardless of the time (15 minutes from now or 4 hours from now) there will always be the incredulous "That LONG!?" response. Look, if you had pinpointed a time as I had offered, I could begin work on your prescription and it may be done quicker. Since you left the time entirely up to my discretion, I made a decision based on my needs at the moment. Accept it and move on.

When people are in the store, I give them exact times if they choose to wait. In this way, there can be no ambiguity surrounding the Time Of Promise Pickup:
"If you're waiting, that'll be 22 minutes which puts us at 3:57. See you then." It helps, especially since our perception of 22 minutes differs greatly from that of the people on the other side of the counter.

Friday, September 8, 2017

Last One Called Gets All The Yelling!

It's a game.
Make the patient make as many phone calls as possible without actually helping him until he reaches the end of the line . . . and his rope, and begins erupting far away from you. 
Unfortunately, this usually means the pharmacist bears the burden. 

CP: Thank you for calling CP's Pharmacy. Please tell me in what manner you are going to request the impossible so I may disappoint you today. 
Richard Better Use Retail Next Script: I am without my medication. 
CP: That sucks. You should totally get it refilled. Problem solved. Next!
DickBURNS: Wait. I'm waiting on my mail order to arrive. 
CP: Ok. Since you don't use my pharmacy, I fail to see how I can help you. Did you just need someone to talk to while you wait? 
DickBURNS: No. They've been trying to fill my prescription for 2 weeks now. 
CP: It usually takes me about 15 minutes. Two weeks seems like an awful long time to "try" to do anything. 
DickBURNS: Well they say they contacted my doctor and he hasn't responded. They have called him 3 times and I have called him every day for 2 weeks. He still hasn't responded to either of us and now it's the weekend and I am out of medication. 
CP: Boy that's a toughie. First I'd suggest finding a new prescriber. Second, since it's only Thursday, I'd suggest driving to his office and requesting a prescription in person. 
DickBURNS: When I called my mail order pharmacy they told me to come to my local pharmacy and you'd give me my medication. 
CP: <laughs> I love when people tell everyone what my job is and how I do it and believe I can wave a magic wand and damn all the laws I have to phollow. What is this medication? 
DickBURNS: I need Trazodone for sleep. 
CP: Well, upon checking your profile, you have filled exactly 3 prescriptions since 2014 with our pharmacy. Not one of those is for Trazodone. Since your mail order has no prescription, I cannot transfer one from them. Since I have never filled it, I cannot invoke my State's emergency fill exemption so I am unable to help you today. 
DickBURNS: So you're refusing to help me? What am I supposed to do now? They said you'd help me! I need my medication. 
CP: First, you're not my patient. Second, mail order can't tell you what I will do in my pharmacy or my state. Third, I gave you options that included visiting your prescriber. Fourth, there are no options available for you from me other than me giving you other options that do not include me. 
DickBURNS: You're not very helpful. 
CP: Wrong. I was quite helpful. You believe me to be unhelpful because I did not give you the answer you sought when you first rang. There is a difference between your interpretation of helpfulness and the truth. I realise you're phrustrated but your ire is misplaced with me. It instead belongs with your prescriber. Had he done his job, we would not be having this conversation. I stand by my original suggestion, find a new prescriber. Besides, if my state allows me to fill an emergency prescription shouldn't mail order be expected to offer the same service? They are a pharmacy, right?
DickBURNS: But they said you'd do it.
CP: Right. Not cost effective for them. Good luck. Sleep tight. Er . . .

Friday, September 1, 2017

The More You Say It, The Phunnier It Gets

Sometimes, okay, quite often in my pharmacy, a conversation, or a phrase, or even a single word inspires an entire post. The strength of it is directly proportional to the acceptance by my colleagues  of the twist-of-phrase.

It's always inspiring to me that floaters choose to come to my store; mostly due to them knowing they are not in for a drab, boring day. I like to think it's me, but I know better. 

Why is it that patients always say the same thing? It's not just every patient reciting the same line; I'm talking about every patient repeating the same line each time he visits the pharmacy. 

CP: What is your date of birth? 
Pt: I come here all the time. 
CP: Then you know I ask for it every time. You really should be better prepared next time. 

CP: Do you have your insurance card with you? 
Pt: It's in the computer. I come here all the time. 
CP: I think you have a serious problem. Insurances should not be that stimulating. 

CP: Any changes to your personal information?
Pt: I come here all the time. 
CP: I realise corporate pharmacy has prostituted our profession, but you really need to stop doing that. We are not literal prostitutes and since only the pharmacists are Blood and OPIM (Other Potentially Infectious Materials) trained, we're tired of cleaning up your "accidents". 

CP: Do you have any allergies? 
Pt: I come here all the time. 
CP: I'm glad we excite you that much, but you should really try to wait until you get home. They make medication for that. 
Pt: Really? What medications treat that? 
CP: SSRI's are one class. 
Pt: SSRI's? 
CP: Yes. And to help you remember, when you write it down, it actually looks as if the acronym is trying to say "So Sorry". 









Tuesday, August 29, 2017

I Forgot.

It's like riding a bike.
Okay, more like falling off a bike.
We go to school and we learn things.
We go through life and we practice things.
They are as easy as breathing; as driving; as eating.
Until one day . . .
We stop doing them. Idle hands may do the Devil's work, but idle brains wither and die.

Imagine a world where you learn to write and speak your name. You do this before tests and on all paperwork through your adult life. Now imagine that the world changes and you only need to present a biometric ID or retina display to gain access to classes, apply for a mortgage, or complete forms at the BMV or your prescriber's office. No more talking or writing expected.

Will you still remember how to communicate the old way?
Will you remember your name?
How to pronounce it?
How to spell it?
Will there be secret, underground societies comprised of humans who prefer the old, verbal method of greeting one another?

Alas, poor Yorick.

CPP: CP, where are you going with this?
CP: Sometimes events occur in multiples and you wonder if it's a sign of the Apocalypse or a series of unrelated anomalies.
CPP: And last week was?
CP: A number of offices called us with the same issue and their answers were all eerily similar in their stupidity.
CPP: Blamed the eclipse?
CP: Worse. The software.
CPP: Okay. Tell me what happened.
CP: Prescribers go to school, right?
CPP: Most of them. Others, I'm not so sure.
CP: But they learn how to write prescriptions, right?
CPP: What with electronic records, it's become an antiquated practise.
CP: Indeed. But the majority of prescribers out there had to hand write prescriptions at some point, non?
CPP: Oui.
CP: Then why did we receive multiple calls from (and make multiple calls to) offices whose electronic prescribing systems were "giving them fits" and they "forgot how to write prescriptions"? I can understand certain traits of a civilisation eroding over a generation, but within a few years of practise?
CPP: I see what you mean.
CP: We had a control prescription where the prescriber forgot to write his DEA#, spell the quantity, and date the prescription.
CPP: Outrageous! Of course you called the office.
CP: Of course, at which point I received the obligatory "the system was down" excuse from the phone answerer person.
CPP: Remember our math teachers in school always telling us we won't always have a calculator?
CP: I repeat that often. It's why I still do all my calculations on the backs of the prescriptions after doing them in head. I check myself.
CPP: Before you wreck yourself?
CP: The point is, we can still do this. We don't get flummoxed. We don't get upset. There is no perturbation. We can think for ourselves and adapt and do what's right and necessary.
CPP: You really need to do a post about having the ability to think for oneself. Something along the lines of learning HOW to think as opposed to being taught WHAT to think.
CP: Like the one I wrote last week?
CPP: Precisely. 

Wednesday, August 23, 2017

This Is Only A Test. Had This Been An Actual Emergency. . .

CP: Sometimes, all you can do is throw your hands in the air . . .
CP's Partner: . . . and wave them like you just don't care?
CP: . . . and pray for the human race.
CPP: What now?
CP: You know how we're allowed to authorise a refill in an emergency for a patient?
CPP: Yes. We have discussed this at length.
CP: Remind me, and enlighten our phellow phollowers, as to what criteria must be met for this to occur.
CPP: Gladly. First, it must be an emergency.
CP: Defined as?
CPP: The patient must be out of (a life-saving) medication. They must be unable to reach their prescriber. The prescriber's office must be closed. We are permitted to fill enough for the patient up to 1 month, but generally only enough to last the emergency period.
CP: Because if they were open, then they would logically be able to reach the prescriber and he/she would be able to fulfill the obligation of approving a new prescription refill.
CPP: Exactly.
CP: And they could reach the prescriber the next day since it's only Tuesday?
CPP: Yes. Why the rephresher?
CP: That phone call I just took.
CPP: Excellent. More role-playing. I'll be the plucky pharmacist.
CP: And I'll be the patient.

CPP: Hello, this is CP <snickers> How may I be of service?
CP <as the patient> I am out of refills.
CPPasCP: I am terribly sorry to hear this. Again, how may I be of service?
CPasPt: I just got off the phone with my office. They told me that I should call you, tell you when my appointment is and that you will give me enough medication to get me through to my appointment.
CPPasCP: That seems kinda backwards, does it not?
CPasPt: I didn't think that sounded right but thought I'd call since I have a great relationship with y'all.
CPPasCP: You were wise to come to us. Here is what I want you to do. Call back to the office and tell them you spoke with us. Tell them we made you an emergency appointment for 8:45 tomorrow morning so that you wouldn't have to wait 2 weeks to see them since that is ridiculous for such an urgent matter. Since they have bestowed so much power upon us, tell them their faith has been rewarded and you shall see them soon.
CPasPt: I like where you're going with this.
CPPasCP: And when they reply with "that's not how this works", kindly remind them that that's exactly what the pharmacists (both of them) said when you explained that we are supposed to use the emergency clause just because they don't want to be bothered to obey the state laws and call in a refill for you.
CPasPt: Will do. Thanks!

CPP: Such an awesome patient. You do realise we couldn't get away with that with all of our patients.
CP: I do. But just wait until you hear what office this was.
CPP: Really? I've explained this to them for 2 years now. They can't invoke "emergency fill" during normal business hours. It's not an emergency if they are actually IN the office and reachable.
CP: Right? As if we don't already do enough work for them . . . Hey, check the queue.
CPP: Seriously? That was quick.
CP: Must have gotten through to them a lot faster than we anticipated. And look! They wrote it wrong so we have to call them to phix it anyway.
CPP: Guess we should have written our own in the first place.
CP: Nah. Where's the #PharmacyPhun in that?

Another all-too-real-life story brought to you by CP; with special guest appearance by CPP.

Tuesday, August 22, 2017

Do Not Go-Lytely...

Do not Go-lytely into that good night,
The tongue should burn and cry at the first taste;
Rage, rage against the dying of the light.

The fire coming out the end is fright,
Doctor's orders did not prep for haste
Do not Go-lytely into that good night.

Insides, in panic cry, screaming not right
This unwelcome guest that now clears this space,
Rage, rage against the dying of the light.

Four hours to drink with no end in sight
And now, a glass, to assault yet more waste,
Do not Go-Lytely into that good night.

The cramps, in gut, are spasming tight
In knots it turns like anxious days we've faced,
Rage, rage against the dying of the light.

Again, once more, on the seat I alight
Pray this, the end, of my bowels have been chased.
Do not Go-lytely into that good night.
Rage, rage against the dying of the light.




Monday, August 21, 2017

What's Your Birthday?

I learned a long time ago that "First Name" somehow sounds a lot like "Birth Day" to people standing  at a pharmacy counter. As a result I modified my approach to asking for a patient's "Date of Birth". It doesn't mean we still don't receive the wrong answer from time to time. but this image always comes to mind when it does.

No, no, no, no, no, no
No shorty what's your birthday?
I said I need to know what is your birthday?
I needa have all your info what's your birthday?




Wednesday, August 9, 2017

Lice Lice Baby

Yo, R. I. D., let's kick it.

Lice Lice Baby, Lice Lice Baby

All right stop, irritate and scratchin'
Lice is back and it needs some attention
Nits are stuck on the hair so tightly
Can't go to school the nits are unsightly
Will the itching' stop? Damn, I hope so
Stay away from the mayo.
Rakin' the scalp with an itch I can't handle
Gas and a match will burn parasites like a candle

Fwoomp! Shoulda used clippers instead.
Bear can't hide in the trees if there ain't no wood.
Pickin', so hard I broke the comb's handle
Nits attachin' to my roots like a vandal
Head-to-head contact, it's just frowned upon
Parents don't want us kids to get along

Just for this problem Nix will solve it
If that don't work maybe Rid may resolve it.

Lice Lice Baby, Time for Head Lice Lice Baby, Time for Head
Lice Lice Baby, Time for Head Lice Lice Baby, Time for Head

Now the parasites are lurkin'
Resistance is growing and OTC's not workin'
Get to the doctor, to the doctor, for savin'
Scripts are good for lice that's misbehavin'
Treating patients with malathion
Natroba is newer to rely on
Used to use Lindane or a product called Kwell
Robi-comb and LiceMD are new, that's swell
Smilin' for school photos
The girlies sharing combs, teachers screamin' "Hell No!"
Did they stop? No, kept brushin' tho.
Helmets and hats we say don't share 'em
Now they're planning sleepovers and we say forget 'em
Keep lice from spreadin'
So we continue to use coco-nut oil.

Killing all the eggs off is a challenge
Ovicidal meds they just can't manage
Seven days to repeat doses
Pediculicide's no better
Mom's got the comb and Dad's got the razor
Aiming for bugs starting to crawl
Parents freakin' out they got 4 more kids in the hall
Wailing poured out like a banshee
Kids off running, never knew man she
Broke all the windows neighbours heard
Cursing comin' out my mouth real loud
Drew the police, then a small crowd
Parents and children, thankful it's not them
Of scratching and itching now dealing with this problem
Mention lice in passing, everyone scratchin'
Hands to their heads in reflexive action.

Just for this problem Nix will solve it
If that don't work maybe Rid may resolve it.

Lice Lice Baby, Time for Head Lice Lice Baby, Time for Head
Lice Lice Baby, Time for Head Lice Lice Baby, Time for Head
Lice Lice Baby.